| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $536.97 | $5,236.55 | $11,642.00 | |
Medica
| Professional | $773.80 | $1,083.32 | $4,655.12 | |
United
| Facility | $9,059.25 | $9,059.25 | $9,059.25 | |
United
| Professional | $719.99 | $1,122.01 | $1,560.70 |